Diabetes Prevention and Management by lay health workers in Nepal

Diabetes Prevention and Management by lay health workers in Nepal

Donor: World diabetes foundation [WDF]

     1. Objective of the project 

  • To raise awareness in the general population about pre diabetes and diabetes and its complications by reaching out to at least 55000 people. 
  • To identify undiagnosed subjects with type 2 diabetes and pre diabetes through opportunistic screening. 
  •  To train 143 female community health volunteer of lekhanath municipality for screening blood sugar and empower them to disseminate family based home health education to every household in community. 

 

     2. Project area

  • Pokhara metropolitan city ward number 26 to 33. 

 

     3. Snapshot of project activities 

S.N    Activities
 Approval from Metropolitan and Social welfare council
 1.1 IEC materials poster and pumplets
 1.1.1 Review and preparing IEC materials
 1.1.2 Printing of IEC materials
 1.1.3 Distribution of IEC materials
 1.2 School health program
 1.2.1 Preparing booklet about T2DM and CVDs
 1.2.2 Training of school teachers 
 1.2.3 School session on diabetes and CVDs
 1.2.4 Refresher training for school teachers
 1.3 Radio jingles production and airing
 1.3.1 Radio promotion 
 1.4 Newspaper articles on T2DM
 1.4.1 Publication of layman articles in newspapers
 1.5 Celebration of special events with focus on T2DM
 1.5.1 Debate and quiz competition
 1.5.2 Running events
 1.5.3 Cycling events
 1.5.4 Documentary show
 2.1 Screening of T2DM
 2.1.1 Procurement of equipment 
 2.1.2 Organizing free blood sugar screening camp
 2.1.3 Refreshment for participant
 2.1.4 Advocacy about screening
 2.2 Established link with health facilities
 2.2.1 Orientation to local health facility staffs
 2.2.2 Refresher training to health facility staffs. 
 3.1 FCHV contributed to diabetes prevention and control by successfully undertaking blood glucose measurement and blood pressure and disseminating information regarding healthy lifestyles as a part of their job responsibilities.
 3.1.1 Training of FCHVs on T2DM screening and prevention 
 3.1.2 Production of a training manual
 3.1.3 Training of FCHVs (5 days) 
 3.1.4 Distribution of glucometer and other teaching aids for FCHVs
 3.1.5 community based screening and referral (FCHV home visit)
 3.1.6 Refresher training
 3.1.7 Supervision and monitoring
 4.1 Coordination among stakeholders
 4.1.1 Formation and bi-annual meeting of project advisory committee
 4.2 Monitoring and evaluation system established and functional
 4.2.1 Development of monitoring framework
 4.2.2 Monitoring visit
 4.3 Advocacy and dissemination 
 4.3.1 Advocacy to discuss project outcomes and disseminate project findings 
 4.4 Improvement from baseline indicators to Endline indicators
 4.4.1 Baseline and Endline survey
 Covid Response (Helmet Doctor) 

 

      4.Benefits of the project

  • Awareness about type 2 diabetes and its complication is raised among at least 55000 community people through direct public education and its mass media campaign. 
  • Status of type 2 diabetes and pre diabetes is known by the community people. 
  • FCHV contributed to diabetes prevention and control by successfully undertaking blood glucose measurement and disseminating and disseminating information on healthy lifestyle and information as a part of their job responsibilities. 
  • Diabetes management is improved by FCHV led blood sugar screening and health promotion counseling.

 

      5. Project duration 

         15th September 2017 to 15th September 2021

 

      6.Collaborators

  • Pokhara Metropolitan City 
  • Health posts and urban health centers 
  • Shishuwa Hospital 

 

What we give to people

Success Stories

  • Harilal Tiwari of Lekhnath-32 is a 58 years old male. He hasbeen a smoker and consuming alcohol for a long time. Ignoring the suggestions from his family and health workers, neither  did he  quit smoking nor  drinking harmful amount of alcohol.

    Debka Tiwari, a female community health volunteer(FCHV), said when measuring this person’s  blood pressure, it was found high and she  advised him to go to the hospital immediately for a quick management and treatment. But due to the fear of being prescribed for a  medicine, he did not go to any health facility for the treatment of high blood pressure.  Unfortunately, he died within a matter of a few days due to cardio-vascular disease. 

    “We have lost a lot of lives due to neglected non-communicable diseases,” said Tiwari, a female community health volunteer.

    लेखनाथ ३२ का हरिलाल तिवारि ५८ बर्षको हुनुहुन्थ्यो । उँहाले लामो समयदेखि धुम्र्रपान र मादक पदार्थ सेवन गर्नुहुन्थ्यो । परिवार र अन्य स्वास्थ्यकर्मि हरmको सुझाब लाई बेवास्ता गर्दैं मादक पदार्थ सेवनमा कत्ति कम गर्नुभएन ।
    बारम्बार स्वास्थ्य स्वयंसेविका देबका तिवारीले रक्तचाप मापन गर्दा बडी देखिएको र तत्काल अस्पताल जान सल्लाह दिनुहन्थ्यो । तर औषधी सेवन गर्नुपर्ने डरले जँचाउन जानुभएन । एकाएक ज्यानै जाने अवस्थासम्म आइपुग्नुभयो र त्यसको केही दिनमा उच्च रक्तचापको कारणले उँहाको ज्यान गयो ।
    स्वयंसेविका तिवारीले हामीले वास्ता नगरेकै रोगले गर्दा कँयौ को ज्यान जाने गरेको बताउनुहुन्छ ।

  • A 93-year-old cancer patient, Mr. Bhimlal Shrestha was looking for someone to help him to get his regular medicine. He had to take a medicine named Calutide 50 every day. According to the health coordinator of Rupa rural municipality, on 31st May Shrestha reported that his medicine will be finished in next few days. After the implementation of Helmet Doctor project in Rupa rural municipality, the son of Shrestha informed us about the problem they are facing due to lockdown.  Our staff of the Helmet Doctor project went to various pharmacies in search of the medicine but the medicine was already out of stock in the town. We came to know that the medicine is available in one of the medical shop in Chitwan district situated 125 km south-east of Pokhara. Due to lockdown, it was impossible for us to go over there. The patient shared that he had severe bleeding from penis due to lack of the same medicine  in the beginning of March 2020. At that time, he was not able to take medicine for 5 days. This made us more emotional and pushed us to help him as soon as possible. After finding the exact address of the medical shop in Chitwan, and with the coordination with one of the staff of Nepal Development Society (NeDS) in Chitwan, they facilitated  sending the medicine from Chitwan to Pokhara.  We were able to receive medicine at 8:00 pm on 5th June 2020. Then the next day which was a Saturday, we reached   the patient at his door-step to handover 100 tablets of the medicine to his son. Had it been one-day delay, the patient would have to miss his regular dose. The son thanked us and our team for the rapid response.

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